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Case Reports
. 2023 Oct 9:2023:5550451.
doi: 10.1155/2023/5550451. eCollection 2023.

Femoral Neck Fracture in a Pediatric Patient with Primary Hyperparathyroidism

Mark W Schmitt  1 , Maxwell J Modrak  2 , Soumar J Bouza  3 , Brian G Smith  4 , Murillo A Adrados  1
Affiliations
Case Reports

Femoral Neck Fracture in a Pediatric Patient with Primary Hyperparathyroidism

Mark W Schmitt et al. Case Rep Orthop. .

Abstract

Case: A previously healthy 11-year-old girl underwent expedited surgical fixation of a femoral neck fracture sustained while jump-roping. After further work up, she was diagnosed with primary hyperparathyroidism. Parathyroidectomy of a hypertrophic adenoma proved curative. Now, five months post left hip surgery, the patient is pain-free and walks without a limp.

Conclusion: We describe the first published case of primary hyperparathyroidism presenting as a pathologic hip fracture in a child. Although presentation with a fracture is exceedingly rare, bone pain is a frequent complaint of pediatric hyperparathyroidism. Orthopedic surgeons may find themselves the front-line caregivers for the condition.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Initial X-rays demonstrating a Delbert type III left-sided femoral neck fracture.
Figure 2
Figure 2
Intraoperative fluoroscopy demonstrating closed reduction utilizing a traction table and placement of two 6.5 mm screws for fixation.
Figure 3
Figure 3
Mandibular X-rays on hospital day 2 displayed a lytic lesion with cortical breakthrough adjacent to the mandibular symphysis and a small area of erosion at the mandibular angle.
Figure 4
Figure 4
Hematoxylin and eosin stain at 100x magnification of the resected parathyroid gland demonstrating a well-circumscribed with mass with eosinophili cells that exhibit large atypical nuclei with prominent nucleoli.
Figure 5
Figure 5
Cyclin D1 staining of the resected parathyroid gland shows diffusely positive staining for cyclin D1.
Figure 6
Figure 6
X-rays taken at 5 months postop demonstrate healing of the femoral neck fracture in some varus with some shortening of the femoral neck.
See this image and copyright information in PMC

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